The concept of outreach primary care training for undergraduates was pioneered more than 30 years ago at Manchester Dental School, and since then has become established as an essential aspect of dental undergraduate training in the UK.
Outreach programmes vary widely from dental school to dental school, some operating outreach training in blocks and others operating a rotation scheme with students working in an outreach clinics once every few weeks. September 2007 saw the opening of the UK’s first dental school in 40 years, Peninsula Dental School, which has, due to increasing student intake numbers, set aside the conventional hospital-based training programme in favour of an entirely outreach-based model.
The NHS are opening increasing numbers of community health centres nationwide, frequently containing dental clinics to provide communities with much needed NHS services. This has enabled patients to gain access to dental care they may otherwise have been unable to attain or afford. Dentistry in these community dental services is provided predominantly by community dental officers and visiting general dental practitioners, however as outreach schemes develop and dental student numbers increase more patients are being treated by undergraduates.
Outreach training is a popular aspect of the undergraduate curriculum with both students and staff as it provides an ideal opportunity to experience dentistry in a primary care setting within the community. The training is frequently supervised by GDPs or community dental officers, giving students a taste of the practice environment prior to graduation.
Another advantage is the opportunity for students to work with their own dental nurse, enabling a greater appreciation of team working. This, coupled with smaller teaching groups, allow students to increase their productivity without compromising the quality of treatment provided.
Digital software learning
Many outreach centres use computerised management software for record keeping, very similar to that used in dental practice, which enables students to gain vital experience in operating these systems.
Digital dental radiography, rotary endodontic and air abrasion equipment may also be available, along with alternative equipment and materials students may not be familiar with, broadening their range of clinical skills.
The patients treated in outreach centres are often different to those undergraduates may usually be exposed to. Many patients using these community facilities may have physical or mental disabilities, may speak limited English and/or have a severely neglected dentition which may pose challenges to the operator, improving patient management skills.
Often, due to the nature of patient referrals to secondary dental care, patients requiring routine dental treatment are rarely seen in the dental hospital setting. Time in
primary care allows students to gain experience in treating more common dental problems, improving confidence in clinical ability.
However, outreach training is not without problems. Many students have difficulties with patients failing to attend appointments, leading to significant amounts of wasted clinical time. The training programmes are also expensive and require a significant amount of time and money to organise and staff efficiently.
Overall, students are very positive about their undergraduate outreach experiences, and feel that this aspect of the course provides them with broader clinical experience, preparation for working in a practice environment and a greater awareness of potential dental careers available.